The Value based healthcare prize 2018, an international prize dedicated to the so-called “value medicine”, was held on Thursday 26th April in Nijkerk near Amsterdam. The prize aims to evaluate hospital routes in terms of both clinical results and costs, using well-defined criteria.

Humanitas, and in particular the review of the course of patients operated in bariatric surgery, won the prize in one of the four categories in competition, winning the Patient Outcomes Award. The jury awarded the multidisciplinary approach towards the patient, the results obtained (the outcomes) both clinically and in terms of PROM (patient reported outcome measures) and the sustainability of the project.

140 projects applied for the Value based healthcare prize 2018; 40 of them were invited to submit abstracts of their work and 12 were the finalists. Humanitas, the only Italian reality in the race, won in one of four categories, the first international candidate to have won during the 5 years of this event.

 

The project and the jury

The project was coordinated by the engineer Giulia Goretti, responsible for Lean, and by Dr. Chiara Ferrari, responsible for the anesthesia service for bariatric surgery, and presented on behalf of the entire multidisciplinary team of Dr. Giuseppe Marinari, head of bariatric surgery.

The award day began with a lecture by Prof. Bohmer on value-based healthcare and ended with a speech by Prof. Porter on the impact of value medicine on health systems and patients themselves.

Between the two speeches, the 12 finalists had the opportunity to present their project.

The jury was composed of Prof. Kaplan, Sir Muir Gray, Prof. Teisberg, Prof. Akerman, Prof. Friedman, Prof. T. Savange, Prof. Lega and Prof. Deersberg-Wittram, among the most authoritative academics and exponents of management in health care, development of value medicine, measurement of outcomes, the most important international universities including Harvard Business School and institutions such as ICHOM.

 

The revision of the bariatric surgery course

In 2016, Humanitas launched a project to review the pathway of patients undergoing bariatric surgery. Bariatric surgery is one of the clinical excellences of Humanitas and therefore the valuable work carried out has made it possible to further improve an already highly virtuous process, perfecting some aspects.

This work has started the review of other excellent hospital routes, acting as a prototype in terms of quality and continuous improvement of processes, to the benefit of patients, staff and with a view to sustainability with attention to costs.

One of the main novelties of this review process was the inclusion of patient reported outcome measures (PROMs). Not only were the results evaluated in terms of clinical outcomes, but also one year after discharge after the operation, the patients were contacted to fill out a questionnaire, in order to understand how they had lived in the intervening period. The data collected showed, for example, that patients had reduced comorbidities as a result of significant weight loss and had therefore been able to reduce their medication intake, that they had been able to work in better conditions or that they had resumed their sexual activity, which was often compromised by obesity, and that they had finally been able to buy clothes in common and unspecialized shops for obese people.

 

Multidisciplinary approach and patient focus

The jury that awarded Humanitas the Patient Outcomes Award also recognized the importance of a multidisciplinary approach to patients. Bariatric patients are in fact involved from the outset with a multidisciplinary framework, which in the forefront sees the surgeons, but also other figures such as the psychologist, the dietician, nurses and anesthetists. A group moment is dedicated to the patients, in which the professional figures who will accompany them during the journey, the hospital and the journey itself are introduced, so that they are immediately motivated and involved in the first person and thanks to a greater awareness of what awaits them, they can feel that they are active and responsible protagonists of their own path of treatment. An educational approach that also involves family members, so that they can in turn support and encourage their loved ones at such an important time for their health and life.

Patients undergoing bariatric surgery are encouraged to get out of bed, walk and drink already 30 minutes after surgery is completed, all of which reduce the risk of thrombosis and pneumonia and help control nausea and postoperative pain. They are therefore called upon personally and immediately to take charge of their own health, working on their lifestyle. Dismissal takes place after two days and after a week patients are contacted by the case manager who informs them about the general conditions, pain management and the presence of any symptoms, so as to promptly intercept any emerging problems.

“We are proud and happy with this important international award for Humanitas. We would like to thank Elena Vanni, responsible for management control, and Marco Albini, responsible for quality monitoring, for the team work that led us to nominate for the award; Dr. Giuseppe Marinari, responsible for bariatric surgery and his entire team, consisting of doctors, nurses and staff, who make this work possible every day; Dr. Patrizia Meroni, health director of the Humanitas group, who supported us in this project and we wish to dedicate the award to patients and caregivers, true protagonists of the journey”, underlined Giulia Goretti and Chiara Ferrari.

 

Humanitas at the International Forum on Quality and Safety

The project was also presented with a poster at the International Forum on Quality and Safety in Healthcare, which took place in Amsterdam at the beginning of May, and was well received as an example of quality on the international healthcare scene.